And while we celebrate the fact that this little white girl will live a while longer, let's not lose sight of the fact that someone else will die because the lungs that could have saved him or her were given to someone who, prior to a judge's order, was not eligible. Until there are enough organs to go around, it's always a trade of a life for a life. The decision of which to choose should not be made by a judge.

thehobbes:Sadly there is the business aspect of organ harvesting as well. Ever see a limousine in front of an ER/hospital entrance? Normally its a transplant team. Ever wonder why hospitals don't transfer the patients all to the same hospital for the harvest (which would decrease out of body time on the organs, increasing viability). They instead pay to fly the harvest teams in, pay for ambulances (ground and flight) to transport the organ to and from the airport where they have a private chartered plane fly the organ to the destination city.

Hospitals make bank and tend to want to keep the patient in order to keep the cash flowing in.

Great Janitor:Jim_Callahan: The reason there are delays is selfish bastards like you, assuming you're not an organ donor. I guess you could be but statistically it's unlikely so I'm rolling the dice and blaming you personally anyhow.

I can not be an organ donor. I found this out 12 years ago when I went to sell plasma. There are places that if you lived there during certain time periods you are prohibited from organ and blood donation as well as selling plasma. Since I lived n the wrong country at the wrong time, I fall into the category of barred from donation, even though I am in great health. I tried lying but I still have the accent.

well, aren't you special. so very, very special.second guessing the medical community and trying to lie and put people at risk of dying.I am glad you failed in your lying.

TemperedEdge:"Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

FizixJunkee:thehobbes: Sadly there is the business aspect of organ harvesting as well. Ever see a limousine in front of an ER/hospital entrance? Normally its a transplant team. Ever wonder why hospitals don't transfer the patients all to the same hospital for the harvest (which would decrease out of body time on the organs, increasing viability). They instead pay to fly the harvest teams in, pay for ambulances (ground and flight) to transport the organ to and from the airport where they have a private chartered plane fly the organ to the destination city.

Hospitals make bank and tend to want to keep the patient in order to keep the cash flowing in.

LOL wut?

If they transfer the patient to a different hospital, they don't get the money from the ensuing ICU stays, OR time, dozens of other medical expenses. Plus they get the possibility of good PR and possibly being listed in a medical journal. The transplant services themselves also do lobby and schmooze hospital staff with pens, meals, other small accessories much like the pharmaceutical industry does.

Worldwalker:And I still think that having judges, not doctors, make decisions about organ transplants -- especially when lawsuits, media coverage, and public pressure get involved -- is a bad idea

I completely 100% agree with this. But then again, I am one of those weird people who believes that we'd have cheaper and better healthcare if we left the courts out of the hospitals and limited the role of the government in the hospitals. For example, I broke my hand on Sunday. Broke the 4th metacarpal in two on my right hand. In triage the nurse had to ask me, by law, questions about if I was thinking of hurting myself in the past 30 days or if I was living in fear of spousal abuse when I go home. On the surface these sound like good questions. However, even if the answer is yes, who'd say it?

FizixJunkee:thehobbes: Sadly there is the business aspect of organ harvesting as well. Ever see a limousine in front of an ER/hospital entrance? Normally its a transplant team. Ever wonder why hospitals don't transfer the patients all to the same hospital for the harvest (which would decrease out of body time on the organs, increasing viability). They instead pay to fly the harvest teams in, pay for ambulances (ground and flight) to transport the organ to and from the airport where they have a private chartered plane fly the organ to the destination city.

Hospitals make bank and tend to want to keep the patient in order to keep the cash flowing in.

LOL wut?

My mother recently had replacement knee surgery. The operation itself was 4k. The few days stay in the hospital after the surgery? Additional 60k. To lay in a bed and be looked in on.Isn't relevant to the story here but yes I agree, hospitals make bank the longer you are there.

thehobbes:Sadly there is the business aspect of organ harvesting as well. Ever see a limousine in front of an ER/hospital entrance? Normally its a transplant team. Ever wonder why hospitals don't transfer the patients all to the same hospital for the harvest (which would decrease out of body time on the organs, increasing viability). They instead pay to fly the harvest teams in, pay for ambulances (ground and flight) to transport the organ to and from the airport where they have a private chartered plane fly the organ to the destination city.

Hospitals make bank and tend to want to keep the patient in order to keep the cash flowing in.

/Pretty sure LifeShare in my state helped fund the groups that repealed the state's helmet law for anyone over 18.... They also required increased medical insurance for the motorcyclists.

That's because they prep the organs to extend viability by various methods instead of just flying them around as part of a rotting corpse, not to mention a small cooler of organs is easier to move than a whole meatbag, along with the fact that donor gets shared by multiple sickies. And the reason they don't fly the sick to meet the organs is because they're too sick to do basic things like maintain body functions so they get to be a poorman's cyborg at the hospital and shiat in bed pans while they wait for somebody to have bad luck or be a moron.

tenpoundsofcheese:Great Janitor: Jim_Callahan: The reason there are delays is selfish bastards like you, assuming you're not an organ donor. I guess you could be but statistically it's unlikely so I'm rolling the dice and blaming you personally anyhow.

I can not be an organ donor. I found this out 12 years ago when I went to sell plasma. There are places that if you lived there during certain time periods you are prohibited from organ and blood donation as well as selling plasma. Since I lived n the wrong country at the wrong time, I fall into the category of barred from donation, even though I am in great health. I tried lying but I still have the accent.

well, aren't you special. so very, very special.second guessing the medical community and trying to lie and put people at risk of dying.I am glad you failed in your lying.

I was lying to sell plasma. Now, keep in mind that before the new rules went into place, I was already donating blood and selling plasma. Then the rules changed and I was disqualified. If my plasma was bad, they didn't find any problems before and the damage was already done. Plus I am not in bad health due to my blood.

Also remember, things that also disqualify you for blood donation and plasma selling include prostitution (visiting and being one), being from or visiting the vast majority of Africa, drug use and men who have had gay sex (though, rumor has it, that is no longer a ban, but why can I have butt sex with Rachel and it's just peachy, but have butt sex with her brother and suddenly I'm barred from blood donation?).

I don't worry about it any more. It only matters when the boss man wants us all to donate to the blood mobile when it comes to the office. I explain and it's all good.

Carlip:Smart, give the lungs to a fat girl, with fat parents so they can crowd up earth. Maybe the government should get a self-restraint transplant for these obese farks.

You're probably just another asshole who's never heard of prednisone and is unaware of its role in treating lung inflammation in cystic fibrosis patients. But honestly, there's no circle of hell deep enough for you.

flemardo:thehobbes: Sadly there is the business aspect of organ harvesting as well. Ever see a limousine in front of an ER/hospital entrance? Normally its a transplant team. Ever wonder why hospitals don't transfer the patients all to the same hospital for the harvest (which would decrease out of body time on the organs, increasing viability). They instead pay to fly the harvest teams in, pay for ambulances (ground and flight) to transport the organ to and from the airport where they have a private chartered plane fly the organ to the destination city.

Hospitals make bank and tend to want to keep the patient in order to keep the cash flowing in.

/Pretty sure LifeShare in my state helped fund the groups that repealed the state's helmet law for anyone over 18.... They also required increased medical insurance for the motorcyclists.

That's because they prep the organs to extend viability by various methods instead of just flying them around as part of a rotting corpse, not to mention a small cooler of organs is easier to move than a whole meatbag, along with the fact that donor gets shared by multiple sickies. And the reason they don't fly the sick to meet the organs is because they're too sick to do basic things like maintain body functions so they get to be a poorman's cyborg at the hospital and shiat in bed pans while they wait for somebody to have bad luck or be a moron.

Outside of family concerns for locality, most patients can be prepped for transport. Outside of someone actively getting ECMO (and some highly trained flight crews can handle that even). Liver failure patients, there isn't really a constant machine keeping them going, Intraaortic balloon pumps are becoming more portable, an intubated patient and transport ventilators are easy, Dialyze the patient before transport for renal failure.... Pumps are portable as well and PICC and central lines are easily maintained.

Crews do critical transports all the time. If anything a good transport crew (RNs and Medics) actually pay closer attention due to it being a 2 provider to 1 patient ratio instead of the 1:1 or 1:2 ratio of an ICU. I still can't see how it makes more sense to cool the organ (and there isn't much more to do than that) and have EMS/some areas PD run the organ emergent to save time to get the organ in place than move the meatbag. The cyborg is going to be shiatting itself anyways, can do it in either city.

He admitted he was a thief a few years ago as well. Thread 5135020 he admitted to depriving someone of property and justified it in the same thread. Cause criminal activities are fun and harmless, or something.

what i'm not seeing mentioned by anyone is the fact that we are headed for an even more "bureaucratic" government administered health care system. are you sure you want the IRS in charge of your health decisions? shouldn't that be between you and your doctor? not you and your government?

davidphogan:tenpoundsofcheese: well, aren't you special. so very, very special.

He admitted he was a thief a few years ago as well. Thread 5135020 he admitted to depriving someone of property and justified it in the same thread. Cause criminal activities are fun and harmless, or something.

I can't even remember the names of the people I talk to in threads.That's certainly a gift you have there.

thehobbes:That's because they prep the organs to extend viability by various methods instead of just flying them around as part of a rotting corpse, not to mention a small cooler of organs is easier to move than a whole meatbag, along with the fact that donor gets shared by multiple sickies. And the reason they don't fly the sick to meet the organs is because they're too sick to do basic things like maintain body functions so they get to be a poorman's cyborg at the hospital and shiat in bed pans while they wait for somebody to have bad luck or be a moron.

Outside of family concerns for locality, most patients can be prepped for transport. Outside of someone actively getting ECMO (and some highly trained flight crews can handle that even). Liver failure patients, there isn't really a constant machine keeping them going, Intraaortic balloon pumps are becoming more portable, an intubated patient and transport ventilators are easy, Dialyze the patient before transport for renal failure.... Pumps are portable as well and PICC and central lines are easily maintained.

None of what you're saying remotely makes the slightest bit of sense if you actually work in healthcare. A critically ill patient is never "easy" to transfer and is *always* more unstable when being transferred. With our highly unstable patients, we often don't go down the hall to CT without at least two RNs, RT, and a doctor. What if your liver patient bust a varice while being transferred? Neither the medic nor the RN can band it. You're SOL.

Not all hospitals have the ICU monitoring capabilities or the surgical specialists to deal with a transplant. And we fly in surgical specialists all the time to harvest organs. I work at a large academic teaching center. We do livers and kidneys and hearts. Our last harvest -- we flew in the heart team from NYC, an eye team from Texas, and a lung team from...Iowa I think? And the organs got distributed all over the US. The heart patient was in NYC so the heart team flew in, took the heart, and then took it back to NYC to transplant.

Liver patient busts a varices? You're right. That person will need banding that can be done quickly however if it is a large variceal rupture, odds are they won't even make it to the procedure even in the hospital, and if small bleeding, fluids and reversing coagulation can buy time.

That person does need an endoscopy pretty quickly. However in our hospitals the doctor doesn't follow ICU patients to the CT, (Exception is trauma services). As far as routine ICU patients, normally i see a tech, RT, and RN going for transport. Rarely have I ever seen the docs following patients to the scanner, and even if they did, they don't have the scope or a Blakemore tube in hand during that transport to CT. So yes, if the ticking timebomb randomly goes off that is more poor luck than anything else, but if a bad enough bleed they couldn't be stabilized, they're SOL anyways.

Not really sure how being moving necessarily *always* makes a patient more unstable. Its less controlled for sure, but with good transport crews and training the risk will be mitigated. Many times flight crews assist, especially in rural areas, in the stabilization of the patient in the ER. Hell, many of our flight services have Nurse Practitioners in the flight nurse role as is, and NICU/ECMO teams are now having mid level practitioners on the transport crew. Air transport in my area even has tube thoracostomy and pericardiocentesis as an advanced paramedic level skill.

Your second paragraph is where I agree with you. However it makes much more sense to move the patient's and donor to the same location where you have more highly specialized facility/equipment/personnel, instead of moving everything/everybody separately, with the greater benefit of not worrying about losing the viability of an organ due to delays. Unexpected delays happen, and being from Oklahoma, weather is always a huge factor and it would be horrible to lose an organ due to the weather delaying the transplant team's flight.

/I've gotten to watch a few harvests, it's a gutwrenching experience for sure.

tenpoundsofcheese:JPINFV: TemperedEdge: "Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

Because we can grow lungs in factories now? Scarce resources require rationing, and since we can't magic up organs yet, they tend to be rather scarce.

If people cared about healthcare, they would volunteer one of their lungs.But no, it is always take someone else's lung or wait until they die.

If it was my own lung would be available, if needed. How did this family make the news and get right to the top of the food chain? That's what amazes me.

TemperedEdge:"Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

Lt_Ryan:TemperedEdge: "Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

The controversy should be why the Federal Government has to step in to override an organization created by the Federal Government.

It will only get worse:

Anybody find it odd that a healthcare program needs an enforcement agency and that agency is the IRS?

TemperedEdge:"Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

Hm, I dunno, because things like replacement organs....aren't readily available and need exceeds supply? Hearts for everybody!

TemperedEdge:"Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

I'm not a doctor, nor do I don't play one one TV. But I'm guessing that the statute in question applied to whether or not adult lungs would even FIT in the body of someone who is only 12.

In most cases, that would almost certainly be relevant. In this case, she appears to be a pretty robust little girl, and her chest cavity had the room. And for a change, the courts looked at this quickly, and made the decision in time to literally save her life.

hasty ambush: Lt_Ryan: TemperedEdge: "Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

The controversy should be why the Federal Government has to step in to override an organization created by the Federal Government.

It will only get worse:

[subconch.files.wordpress.com image 645x992]

Anybody find it odd that a healthcare program needs an enforcement agency and that agency is the IRS?

Nope, I don't.This thing is a screwjob not unlike social security. It starts by offering an essential service (that you pay for, with your money) and slowly twists into a handy expense account for politicos to dip into (both by increasing the overhead for this service and by directly raiding the accounts for cash).Next thing you know your hard earned cash is being used to openly pay off the insurance lobbyists at a higher cost than what it would have taken to simply buy the health care system.

The IRS is run by unscrupulous imps who are accustomed to judging people by numbers on a sheet of paper. They'll have no problem metering out fines like a bureaucratic "death panel" and there isn't a Medic in the loop to say otherwise.Just thousands of arbitrarily applied rules.

/...and its a disturbing thing when we've come to the point where saving a young girls life is controversial./Its understandable that people die for lack of an organ, but not so much when they die because of a "you must be this tall to ride" placard at the hospital entrance./It should have been left at a doctors discretion, not a bureaucrats.

YixilTesiphon:So was this a permanent rule change based on rational considerations brought up by this case, in which case that is fine, or was this "little white girl gets put in front"? Because that's bullshiat.

Between that and the media portrayal pulling on everyone's heart strings and the repercussions of exploiting this family's troubles for monetary gain in ratings... a little of column a, a little of column b.

For the most part medicare at least keeps its administrative costs down and no profit incentive. Having federal employees doing the enforcement versus letting the market decide isn't a bad thing.

kombat_unit:I read 3 other kids in the same hospital were in the same under 12 boat. I hope her parents visit their graves if they should perish without donor lungs.

Actually, when this girl got placed on the adult list instead of the pediatric list each of those kids got bumped up a place, just like they would if she got a pediatric lung or died (she was already at the top of the pediatric list). On the other hand, those parents now get to see a kid get special treatment because her parents were able to hire lawyers.

way south:hasty ambush: Lt_Ryan: TemperedEdge: "Controversial" lung surgery? The controversy should be why she - and anyone else for that matter - should be made to wait absurd amounts of time and have to jump through absurd amounts of hoops to get the treatment they need.

The controversy should be why the Federal Government has to step in to override an organization created by the Federal Government.

It will only get worse:

[subconch.files.wordpress.com image 645x992]

Anybody find it odd that a healthcare program needs an enforcement agency and that agency is the IRS?

Nope, I don't.This thing is a screwjob not unlike social security. It starts by offering an essential service (that you pay for, with your money) and slowly twists into a handy expense account for politicos to dip into (both by increasing the overhead for this service and by directly raiding the accounts for cash).Next thing you know your hard earned cash is being used to openly pay off the insurance lobbyists at a higher cost than what it would have taken to simply buy the health care system.

The IRS is run by unscrupulous imps who are accustomed to judging people by numbers on a sheet of paper. They'll have no problem metering out fines like a bureaucratic "death panel" and there isn't a Medic in the loop to say otherwise.Just thousands of arbitrarily applied rules.

/...and its a disturbing thing when we've come to the point where saving a young girls life is controversial./Its understandable that people die for lack of an organ, but not so much when they die because of a "you must be this tall to ride" placard at the hospital entrance./It should have been left at a doctors discretion, not a bureaucrats.

Vangor:Whazzits: That was fast. Makes me worried that they just bumped her to the top of all lists, instead of putting her behind others who would need lungs more.

Not what happened; she was simply given a new birth date which allowed her to be placed on the ranking system based on several factors to best direct resources in a triage type system. Due to her apparently extremely limited time, expected long life, and health aside from her lungs, she was ranked high.

I understand somewhat why this under twelve rule exists, but seems there should a system which accounts for likeliness of accepting the transplant on factors such as age/comparative size with an amount of priority given. For instance, if you are within X age of a donor organ, your score in the system compared to the donor organ would be boosted by Y%; seems simple.

Expected long life? The news said she will probably be dead in 5 years, even with the transplant.

Mr. Titanium:Vangor: Whazzits: That was fast. Makes me worried that they just bumped her to the top of all lists, instead of putting her behind others who would need lungs more.

Not what happened; she was simply given a new birth date which allowed her to be placed on the ranking system based on several factors to best direct resources in a triage type system. Due to her apparently extremely limited time, expected long life, and health aside from her lungs, she was ranked high.

I understand somewhat why this under twelve rule exists, but seems there should a system which accounts for likeliness of accepting the transplant on factors such as age/comparative size with an amount of priority given. For instance, if you are within X age of a donor organ, your score in the system compared to the donor organ would be boosted by Y%; seems simple.

Expected long life? The news said she will probably be dead in 5 years, even with the transplant.

5 years is your criteria? Isn't 5 years with a reoccurrence of cancer consider a success? What if it gave her 6 more? What if within 5 years they developed a treatment that would buy her another 30 years? What if "they" are wrong (been known to happen ) and she lives another 70 plus and discovers a cure for cancer or brings peace to the Middle East. (conversely you could argue she could be the next Countess Elizabeth Báthory or worse still a feminist I guess)

justajonesin:what i'm not seeing mentioned by anyone is the fact that we are headed for an even more "bureaucratic" government administered health care system. are you sure you want the IRS in charge of your health decisions? shouldn't that be between you and your doctor? not you and your government?

How can I tell you've never had to deal with in any significant way with hospitals and health insurance?

Having dealt with both, I'll be more than happy for the IRS to handle my medical bills. You know why. Maybe the IRS gets things wrong. And the tax code is a little byzantine, thanks congress. But it's nothing compared to insurance and hospital billing rules. With the IRS, if you make a certain amount of money, with normal deductions, you can very precisely figure out what you're going to owe. Try that with a hospital. 'How much for the gall bladder surgery?' They can't tell you, because they have no idea. None.